Related Experiment Video
Updated: Sep 29, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Annual operator volume among patients treated using percutaneous coronary interventions with rotational atherectomy
Rafał Januszek1, Zbigniew Siudak2, Krzysztof P Malinowski3
1Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
Insights
Higher operator experience in percutaneous coronary interventions with rotational atherectomy (PCI with RA) is linked to fewer complications. High-volume operators performing more PCI with RA procedures annually demonstrated better patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Low operator and institutional volume in percutaneous coronary interventions (PCI) correlate with poorer procedural and long-term clinical outcomes.
- This highlights a potential impact of experience on patient results.
Purpose of the Study:
- To evaluate the association between operator experience and procedural outcomes in patients undergoing PCI with rotational atherectomy (RA).
- To determine if higher operator volume impacts complication rates for PCI with RA.
Main Methods:
- Utilized data from the Polish national registry of percutaneous coronary interventions (ORPKI) from January 2014 to December 2020.
- Analyzed 5,188 PCI with RA procedures performed by 851 operators, categorizing operators by annual RA procedure volume.
Main Results:
- Operators in the highest quartile of annual PCI with RA procedures (Q4: >11.57 procedures/year) showed a statistically significant reduction in overall periprocedural complications (p=0.019).
- A nonlinear relationship was observed between annualized operator volume and risk-adjusted outcomes.
Conclusions:
- High-volume rotational atherectomy (RA) operators are associated with a lower incidence of periprocedural complications compared to low-volume operators.
- Increased operator experience, measured by annual procedure volume, is crucial for improving patient safety in PCI with RA.
Background:
Low operator and institutional volume are associated with poorer procedural and long-term clinical outcomes in the general population of patients treated with percutaneous coronary interventions (PCI).
Aim:
To assess the relationship between operator experience and procedural outcomes of patients treated with PCI and rotational atherectomy (RA).
Methods:
Data for conducting the current analysis were obtained from the national registry of percutaneous coronary interventions (ORPKI) maintained in cooperation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study covers data from January 2014 to December 2020.
Results:
During the investigated period, there were 162 active CathLabs, at which 747,033 PCI procedures were performed by 851 operators (377 RA operators [44.3%]). Of those, 5188 were PCI with RA procedures; average 30 ± 61 per site/7 years (Me: 3; Q1-Q3: 0-31); 6 ± 18 per operator/7 years (Me: 0; Q1-Q3: 0-3). Considering the number of RA procedures annually performed by individual operators during the analyzed 7 years, the first quartile totaled (Q1: < =2.57), the second (Q2: < =5.57), and the third (Q3: < =11.57), while the fourth quartile was (Q4: > 11.57). The maximum number of procedures was 39.86 annually per operator. We demonstrated, through a nonlinear relationship with annualized operator volume and risk-adjusted, that operators performing more PCI with RA per year (fourth quartile) have a lower number of the overall periprocedural complications (p = 0.019).
Conclusions:
High-volume RA operators are related to lower overall periprocedural complication occurrence in patients treated with RA in comparison to low-volume operators.
More Related Videos
13:48Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
Published on: April 21, 2023
05:31Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
